Designing an innovative product is all about striking a balance between technological novelty and solidarity with the traditional dynamics and workflows of the industry. Most of the times, it is not a matter of asking Can we?, but rather Should we?
We have always been customer-obsessive, and when designing INSIGHT Scanner it was no different. We adopted the very basic principles of user-centered design and spent some time at Prosthetics & Orthotics clinics observing and asking questions. In fact, some time is quite a euphemism: cumulatively, our team has hundreds of hours spent in Prosthetics & Orthotic Clinics.
No single-socket exists
One of the aspects we quickly noticed we should be sympathetic with was variability. Like in almost every industry, the reality of lower-limb prostheses can get quite messy. Sockets come in all shapes and sizes, varying in height, width, shape, and materials.
Some sockets are very bulky. Others are tailored to children with thin and small stumps. Some sockets need to be scanned with the foot mounted, while others have very short pylons. There is a variety of suspension systems currently in use (from classical pin lock to active vacuum), which in turn influence socket design. Materials-wise, the spectrum is even wider: from transparent check sockets made out of thermoplastics to carbon fiber definitive ones, not forgetting the occasional wooden rarity (we know we have seen them!), considerable variety in brittleness, strength, elasticity, color, and texture exists.
… so let's deal with that
This knowledge of how diverse the workday of a prosthetist has influenced the design of our Scanner in several fundamental levels:
The central component of our scanning solution is a piece that goes inside the socket and sweeps its interior to generate a 3D model and detect pressure sensors, through a combined laser and stereoscopy system. To guarantee it comfortably fits inside any socket, we had to make it as slim as possible while ensuring all required optical componentry could be tightly packed in there. No small feat.
For optimal results, during the scan, the socket should always be static and its central axis (loosely) aligned with the optical piece. Enter the socket gripper. A remarkable piece of industrial engineering born out of several iteration cycles, the gripper is horizontally and vertically adjustable to accommodate sockets of all widths and heights. Buttons conveniently placed on the Scanner's bottom control its horizontal movement, which self-centers the prosthesis. A set of rubberized wheels guarantees a non-invasive, non-slippery grip. Firm yet not too strong, this grips safeguards the brittler materials.
Time is always of the essence
Designing in a sympathetic way is also being mindful of how valuable and in short supply clinical time really is. While designing INSIGHT, we made the time a priority, by making sure we wouldn't take it away.
Making a scan is a mostly plug and play process: open the door, place the socket in whichever orientation you prefer, align it with the help of the gripper's controls, close the door, hit the Scan button on the iPad app and… yes, that's basically it from your side. You can refocus on the patient, as we will take it from there.
The scanning process is entirely automatic, as our optical system moves inside the socket, traces its surface and locates each pressure sensor (so no manual input of their position is required later). In parallel, real-time algorithms are assessing closeness to the bottom and determining when to stop so that no socket contact whatsoever happens. This makes INSIGHT Scanner as frictionless as possible, especially when compared with similar market solutions.
After the physical part of the scan is finished, you can take the socket out, start donning it and connecting INSIGHT Wearable. In the meantime, the captured images are sent to our cloud processing system. There, through computers with powerful graphics cards, and in a highly parallelized and optimized fashion, these images are processed to generate a 3D model of the socket's inner surface with the location of all pressure sensors placed in it. This is possible thanks to our state-of-the-art Machine Learning algorithms for sensor detection and carefully crafted pipelines of computer vision techniques for 3D modeling.
… so let's spend it on what matters
All this so that, at most 90 seconds after the scan finishes, there is a 3D model with the pressure sensors' locations ready in the App. From there, static or dynamic pressure assessments can be immediately started.
With INSIGHT, we want to empower prosthetists. Early on, we recognized that, if we were not cautious, we could hinder their work instead of complementing it. That is exactly why we went to great lengths to make it seamless and put the focus on what matters the most: the patient.
Post written by Daniel Rodrigues in collaboration with Diogo Lopes, Sofia Assis and João Valente.